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What Happens to Survivors of the Adult Respiratory Distress Syndrome?

1994; Elsevier BV; Volume: 105; Issue: 3 Linguagem: Inglês

10.1378/chest.105.3_supplement.123s

1931-3543

Leonard D. Hudson,

Sepsis Diagnosis and Treatment

The original description of the adult respiratory distress syndrome (ARDS) in 1967 1 Ashbaugh DC Bigelow DB Petty TL et al. Acute respiratory distress in adults. Lancet. 1967; 2: 319-323 Abstract PubMed Google Scholar reported a high mortality which was confirmed over the next decade or so by reports from many centers. Despite the high mortality, some consolation was taken from the impression that pulmonary function in most survivors returned to normal or near normal status. This impression was based upon a series of reports, most containing relatively small numbers of subjects with many survivors not accounted for. 2 Downs JB Olsen GN Pulmonary function following adult respiratory distress syndrome. Chest. 1974; 65: 92-93 Crossref PubMed Scopus (31) Google Scholar , 3 Yernault JC Englert M Sergysels R et al. Pulmonary mechanics and diffusion after "shock lung. rdquo; Thorax. 1975; 30: 252-257 Crossref PubMed Scopus (22) Google Scholar , 4 Lakshminarayan S Stanford RE Petty TL Prognosis after recovery from adult respiratory distress syndrome. Am Rev Respir Dis. 1976; 113: 7-16 PubMed Google Scholar , 5 Klein JJ van Haeringen JR Sluiter HJ et al. Pulmonary function after recovery from the adult respiratory distress syndrome. Chest. 1976; 69: 350-355 Crossref PubMed Scopus (39) Google Scholar , 6 Richardson JV Light RW Baskin TW et al. Late pulmonary function in survivors of adult respiratory distress syndrome. South Med J. 1976; 69: 737-740 Crossref Scopus (11) Google Scholar , 7 Rotman HH Lavelle TF Dimcheff DG et al. Long-term physiologic consequences of the adult respiratory distress syndrome. Chest. 1977; 72: 190-192 Crossref PubMed Scopus (30) Google Scholar , 8 Simpson DL Goodman M Spector SL et al. Long-term follow-up and bronchial reactivity testing in survivors of the adult respiratory distress syndrome. Am Rev Respir Dis. 1978; 117: 449-454 PubMed Google Scholar , 9 Yahav J Lieberman P Molho M Pulmonary function following the adult respiratory distress syndrome. Chest. 1978; 74: 247-250 Crossref PubMed Scopus (43) Google Scholar , 10 Lakshminarayan S Hudson LD Pulmonary function following the adult respiratory distress syndrome. Chest. 1978; 74: 489-490 Crossref PubMed Scopus (25) Google Scholar , 11 Shaw RA Whitcomb ME Schonfeld SA Pulmonary function after adult respiratory distress syndrome associated with Legionnaires' disease pneumonia. Arch Intern Med. 1981; 141: 741-742 Crossref PubMed Scopus (10) Google Scholar , 12 Elliott CG Morris AH Cengiz M Pulmonary function and exercise gas exchange in survivors of adult respiratory distress syndrome. Am Rev Respir Dis. 1981; 123: 492-495 PubMed Google Scholar , 13 Alberts WM Priest GR Moser KM The outlook for survivors of ARDS. Chest. 1983; 84: 272-274 Crossref PubMed Scopus (33) Google Scholar , 14 Halevy A Sirik Z Adam YG et al. Long-term evaluation of patients following the adult respiratory distress syndrome. Respir Care. 1984; 29: 132-137 Google Scholar , 15 Fanconi S Kraemer R Weber J et al. Long-term sequelae in children surviving adult respiratory distress syndrome. J Pediatr. 1985; 106: 218-222 Abstract Full Text PDF PubMed Scopus (55) Google Scholar Since that time, a series of studies including three from the University of Utah, 12 Elliott CG Morris AH Cengiz M Pulmonary function and exercise gas exchange in survivors of adult respiratory distress syndrome. Am Rev Respir Dis. 1981; 123: 492-495 PubMed Google Scholar , 16 Elliott CG Rasmusson BY Crapo RO et al. Prediction of pulmonary function abnormalities after adult respiratory distress syndrome (ARDS). Am Rev Respir Dis. 1987; 135: 634-638 PubMed Google Scholar , 17 Ghio AJ Elliott CG Crapo RO Impairment after adult respiratory distress syndrome: an evaluation based on American Thoracic Society recommendations. Am Rev Respir Dis. 1989; 139: 1158-1162 Crossref PubMed Scopus (82) Google Scholar one from the ARDS Specialized Center of Research (SCOR) at the University of Texas, San Antonio, 18 Peters JI Bell RC Prihoda TJ et al. Clinical determinants of abnormalities in pulmonary functions in survivors of the adult respiratory distress syndrome. Am Rev Respir Dis. 1989; 139: 1163-1168 Crossref PubMed Scopus (66) Google Scholar and a recent study from the ARDS SCOR at the University of Washington 19 McHugh LG Milberg JA Whitcomb ME et al. Recovery of function in survivors of the adult respiratory distress syndrome [abstract]. Am Rev Respir Dis. 1994; Google Scholar have provided new information on this subject. Although all of these studies have methodologic limitations, taken together they give us a more complete picture of the ultimate effect of ARDS on pulmonary function, overall functional ability, and the time course of recovery. This presentation will review the data to address the following three questions: (1) What happens to pulmonary function in survivors of ARDS and what is the time course of recovery? (2) If significant pulmonary dysfunction results, what are the determinants allowing its prediction? (3) What is the overall functional ability of survivors of ARDS, and what is the relationship of overall function to pulmonary functional status?